title: Implementation of a diabetes management program for patients in a rural primary care office.
abstract: OBJECTIVE
  A diabetes management program was implemented in a rural primary care office for those who did not choose to consult a multidisciplinary specialty care. The purposes of this study were to describe the current practices and health care provider management of patients with diabetes in a rural primary care office and determine differences between Hispanic and non-Hispanic persons concerning diabetes self-care behaviors, barriers to self-care, and their association with glycosylated hemoglobin level.
  
  
  METHODS
  A retrospective medical record review of diabetes-related medical information was completed.
  
  
  RESULTS
  Sixty-one (74%) of the 83 patients with diabetes completed the questionnaire and had the diabetes management program implemented (problem summary and clinical summary generated). Medical record review was completed for 83 (100%) subjects. Glycosylated hemoglobin was significantly higher for the younger group and women. Hispanic women and married persons had significantly higher glycosylated hemoglobin than did non-Hispanic and unmarried persons. Hispanic persons who were obese had significantly higher glycosylated hemoglobin. Self-care behaviors for managing diabetes were different by group. Non-Hispanic subjects reported taking their diabetes medications 99% of the time and Hispanic subjects 50% of the time.
  
  
  CONCLUSIONS
  It was feasible to implement a diabetes management program in a rural primary care setting, and its implementation highlighted the ethnic differences for Hispanics and non-Hispanics in diabetes self-care behavior, barriers to self-care, and family support for diabetes management. The implementation of the diabetes management program, though, was time-consuming and costly and was facilitated outside of the usual realm of practice.
authors.affiliation: University of Iowa, Iowa City.
authors.forename: Jeanette M
authors.initials: JM
authors.lastname: Daly
authors.forename: Yinghui
authors.initials: Y
authors.lastname: Xu
authors.forename: Barcey T
authors.initials: BT
authors.lastname: Levy
authors.forename: David A
authors.initials: DA
authors.lastname: Bedell
authors.forename: Michael D
authors.initials: MD
authors.lastname: Marquardt
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Vonderhaar
authors.forename: Paul A
authors.initials: PA
authors.lastname: James
keywords: Hispanic; diabetes management; family medicine; type 2 diabetes